Recalled Initiation and Duration of Maternal Breastfeeding Among Children with and Without ADHD in a Well Characterized Case–Control Sample
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Early environmental influences are increasingly of interest in understanding ADHD as a neurodevelopmental condition, particularly in light of recognition that gene by environment interplay are likely involved in this condition. Breastfeeding duration predicts cognitive development, as well as development of brain white matter connectivity, in areas similar to those seen in ADHD. Prior studies show an association between breastfeeding and ADHD but without adequate evaluation of ADHD. A case control cohort of 474 children aged 7–13 years was examined, 291 with wellcharacterized ADHD (71.5 % male) and the rest typically developing controls (51.9 % male). Mothers retrospectively reported on breast feeding initiation and duration. Initiation of breastfeeding was not associated with child ADHD, but shorter duration of breastfeeding was associated with child ADHD with a medium effect size (d = 0.40, p < 0.05); this effect held after covarying a broad set of potential confounders, including child oppositional defiant and conduct problems and including maternal and paternal ADHD symptoms. Effects were replicated across both parent and teacher ratings of child ADHD symptoms. Shorter duration of breastfeeding is among several risk factors in early life associated with future ADHD, or else longer duration is protective. The direction of this effect is unknown, however. It may be that some children are more difficult to breastfeed or that breastfeeding provides nutrients or other benefits that reduce future chance of ADHD.
KeywordsEnvironmental influences Neurodevelopmental condition Breastfeeding Maternal ADHD ADHD Child ADHD ADHD and depression Child ADHD symptoms Breastfeeding ADHD Case–control study
DDS, KH, JS, JTN designed the research; EDM conducted research; EDM, JTN analyzed data; DDS, EDM, JTN wrote the paper and had primary responsibility for the final content. All authors read and approved the final manuscript.
Conflict of Interest
The authors report no conflicts of interest. This work was supported by NIMH MH59105 (Nigg) and by the Bob and Charlee Moore Institute for Nutrition & Wellness at Oregon Health & Science University.
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